Medicines Order

Bulk procurement encompasses that medicines orders are pooled together, that the focus is on the list of priority medicines and that duplication within therapeutic categories is avoided as much as possible. This will result in larger procurement volume and will increase purchasing power. Bulk procurement can be through cooperation of facilities in a country, but positive experience has also been reported from arrangements between states. 

Medicines Order. The Medicines (General Sale List) Order. The Stationery Office Ltd. London, 1997. 

A pharmacy medicine is the definition given to medicinal products not included on the Prescription Only Medicines Order or the General Sale List or to products that are supplied outside the GSL package limit or maximum dosage limit. A few medicines are called pharmacy only (PO) medicines these include medicines that would normally be included on the GSL but where the manufacturer has limited the supply of the medicines to pharmacies only (see Section 1.3.1). Examples include ... 

To allow the pilots for electronic transmission of prescriptions (ETP) to go ahead in England, the Prescription Only Medicines Order was amended to allow authorised prescribers who were participating in the pilot schemes to sign prescription forms digitally in place of ink signatures. 

Further developments in prescribing for health care professionals came with the advent of supplementary prescribing in 2005. Through an amendment to the Prescription Only Medicines Order and NHS Regulations, podiatrists, physiotherapists and radiographers can now train to prescribe in partnership with and independent prescriber (a doctor or dentist) according to an agreed CMP. 

Distribution includes the preparation of the order, the packing and the dispatch by the manufacturer of the medicines ordered. 

Antibiotics are toxic water-solubie compounds produced by molds or bacteria which inhibit the growth of other microorganisms. For an antibiotic to be useful in medicine it should have a high order of selective toxicity to microorganisms which are pathogenic to man. Al-... 

The existence of isotope shifts and of tunable lasers with narrow Hnewidth leads to the possibHity of separating isotopes with laser radiation (113,114). This can be of importance, because isotopicaHy selected materials are used for many purposes in research, medicine, and industry. In order to separate isotopes, one needs a molecule that contains the desired element and has an isotope shift in its absorption spectmm, plus a laser that can be tuned to the absorption of one of the isotopic constituents. Several means for separating isotopes are avaHable. The selected species may be ionized by absorption of several photons and removed by appHcation of an electric field, or photodissociated and removed by chemical means. 

The natural prostanoids have myriad biological effects and held great promise as potential therapeutic agents in numerous diseases. The natural prostanoids, however, also have three notable drawbacks which medicinal chemists have tried to overcome by molecular modification in order to produce acceptable dmg candidates. These drawbacks are rapid metaboHsm which results in lack of activity if taken orally and a short duration of action, numerous side effects due to their multiplicity of biological activities, and poor chemical stabiUty, a characteristic especially pronounced in PGE, -D, and -I stmctures. 

Hesse and Langer say that as a vasodilator yohimbine is the most potent, followed by j9- and a-yohimbines, yohimbene and aitoyohimbine in descending order. Yohimbine is principally used in veterinary medicine as an aphrodisiac. ... 

Ionic bonding was proposed by the German physicist Walther Kossel in 1916, in order to explain the ability of substances such as molten sodium chloride to conduct an electric current. He was the son of Albrecht Kossel, winner of the 1910 Nobel Prize in physiology or medicine for early studies in nucleic acids. 

Epinephrine itself does find some use in clinical medicine. The drug is used in order to increase blood pressure in cases of circulatory collapse, and to relax the bronchial muscle in acute asthma and in anaphylactic reactions. These activities follow directly from the agent s physiologic role. The biogenetic precursor of epinephrine, norepinephrine, has activity in its own right as a mediator of sympathetic nerve action. (An apocryphal story has it that the term nor is derived from a label seen on a bottle of a key primary amine in a laboratory in Germany N ohne... 

Both approaches outlined deliver information that is best used in cycles of medicinal chemistry/computer aided drug design in order to refine the compounds. 

Liquid drag s may also be ordered in drops (gtt) or minims. With die former, a medicine dropper is usually supplied with die drug and is always used to measure die ordered dosage. Eye droppers are not standardized, and dierefore die size of a drop from one eye dropper may be different dian one from another eye dropper. 

An Investigational Medicinal Product Dossier (IMPD) is intended to be more comprehensive than an IB, in that it should contain summaries of available quality data in addition to the safety and efficacy information that constitutes the main part of the IB. In total, it should provide information on the chemistry, manufacture, control and stability ofthe medicinal product, together with the results of non-clinical and clinical studies. In order to avoid repetition, the IB can be cross-referenced for non-clinical and clinical results. Ideally, the IMPD should follow the same structure as that which will be used later for the marketing authorisation application. For products with existing marketing authorisations, the Summary of Product Characteristics may replace the IMPD to varying extents (see Chapter 6). 

Applications to establish MRLs for new pharmacologically active substances must be submitted to the European Medicines Agency (EMEA) at least 6 months in advance of an application for a marketing authorisation. In order to avoid delays, manufacturers are advised to submit an application once all the necessary data are available, as a product authorisation carmot be granted unless established MRLs are in place. The EMEA should be notified of the intent to submit an application 3 to 4 months in advance of the anticipated date, so that a Rapporteur and Co-Rapporteur can be appointed from among the members of the Committee for Veterinary Medicinal Products (CVMP). 

The widespread nature of cell motility is readily apparent, but the attention of this chapter will be focused on phenomena that relate particularly to human medicine in order to accommodate the medical nature of this compendium. 

In order to be successful as part of a medical device a polymer has to resist both biological rejection by the patient s body and degradation. The human body is an enviromnent which is simultaneously hostile and sensitive, so that materials for application in medicine must be carefully selected. The essential requirement is that these materials are biocompafible with the particular part of the body in which they are placed. The extent to which polymers fulfil this requirement of biocompafibility depends partly on the properties of the polymer and partly on the location in which they are expected to perform. For example the requirements for blood biocompafibility are stringent since blood coagulation may be triggered by a variety of materials. By contrast, the requirements for materials to be used in replacement joints in orthopaedic surgery are less severe and materials as diverse as poly (methyl methacrylate) and stainless steel can be used with minimal adverse reaction from the body. 

At the practical level, an ideal mechanistic biomarker should be simple to use, sensitive, relatively specific, stable, and usable on material that can be obtained by nondestructive sampling (e.g., blood or skin). A tall order, no doubt, and no biomarker yet developed has all of these attributes. However, the judicious use of combinations of biomarkers can overcome the shortcomings of individual assays. The main point to emphasize is that the resources so far invested in the development of biomarker technology for environmental risk assessment has been very small (cf the investment in biomarkers for use in medicine). Knowledge of toxic mechanisms of organic pollutants is already substantial (especially of pesticides), and it grows apace. The scientific basis is already there for technological advance it all comes down to a question of investment. 

A supply house, which generally represents several manufacturers, may be nationwide, regional, or local. Many offer a broad range of supplies, while others specialize in certain fields, such as medicine or education. A supply house usually has a will call desk, where an urgently needed item may be picked up within hours after the order is placed. 

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